Med / GI

Question 1

Extraintestinal manifestations of IBD / Crohns or UC

Answer 1

arthritis, uveitis, ankylosing spondylitis, erythema nodosum, erythema multiforme, primary sclerosing cholangitis, FTT, toxic megacolon, anemia of chronic disease, fever.

Question 2

Positive HBsAb means

Answer 2

Patient immune, either in recovery or from vaccination

Question 3

Positive HBcAb means

Answer 3

Patient at some point had an active infection (not just from vaccination)

Question 4

For what patient population might Hepatitis E be fatal? How is it transmitted?

Answer 4

Pregnant women. Transmitted by food and water, no chronic carrier state (like HepA).

Question 5

Jaundice, abd pain, plus antismoothmuscle antibodies or antinuclear ab?

Answer 5

idiopathic autoimmune hepatitis

Question 6

Another name for hepatolenticular degeneration

Answer 6

Wilson’s disease - copper accumulates in basal ganglia and liver and eye. Treat with penicillamine (Chelator). Liver dz and CNS/psych probs

Question 7

Dark urine is found in what type of hyperbilirubinemia?

Answer 7

Conjugated! Unconjugated is too tightly bound to albumin, so is not excreted in the urine.

(Duh, the conjugation is what helps it to get out of the blood! So you also get light, clay colored stools)

Question 8

Courvoisier sign

Answer 8

Jaundice with palpably enlarged gallbladder. Can see with pancreatic cancer causing common bile duct obstruction.

Question 9

Pruritus, jaundice, and positive antimitochondrial antibodies - what is it? how to help sx? how to actually treat?

Answer 9

Primary biliary cirrhosis (in middle aged woman w/o risk factor). Cholestyramine may help. To treat, need liver transplant.

Question 10

Who gets primary sclerosing cholangitis? Sx?

Answer 10

Young adults with IBD (usually with UC). Symptoms similar to bacterial cholangitis: fever, chills, pruritus, RUQ pain.

Question 11

Charcot triad? What does it indicate?

Answer 11

Triad: fever, RUQ pain, jaundice. See in cholangitis.

Question 12

Name an infectious cause of achalasia and where you may see it

Answer 12

Chagas disease (American trypanosomiasis) - see in South America

Question 13

What’s the difference between CREST syndrome and scleroderma? What does CREST stand for?

Answer 13

CREST = the limited cutaneous form of scleroderma.
Calcinosis, Raynaud’s, Esophageal dysmotility, Sclerodactyly, and Telangiectasias.

DIFFUSE: lots of organs can be involved. May see masked facies, GI complaints. Heartburn if LES is incompetent 2/2 fibrosis and atrophy